Disseminated Intravascular Coagulation

• What is disseminated intravascular coagulation (DIC)?


  A haematological emergency characterized by inappropriate activation of clotting cascades
• What are the initial effects of DIC on the body?


  Thrombus formation in microvasculature and depletion of clotting factors and platelets
• What are the key signs and symptoms of DIC?


  Excessive bleeding, fever, confusion, and potential coma
• What are some examples of excessive bleeding in DIC?


  Epistaxis, gingival bleeding, haematuria, and bleeding from cannula sites
• What physical signs are associated with DIC?


  Petechiae, bruising, confusion, and hypotension
• What key investigations are performed for DIC?

  Testing for thrombocytopenia, increased prothrombin time, increased fibrin degradation products, and decreased fibrinogen
• What is the primary focus of management strategies for DIC?


  Treating the underlying cause and providing supportive care
• In what context does DIC often occur?


  In the context of severe systemic disease
• Where is DIC commonly encountered?


  In hospital settings, particularly in intensive care units, surgical wards, and obstetric units
• What is the mortality rate associated with DIC?


  It is associated with a high mortality rate
• What factors influence the outcome of DIC?


  The prompt diagnosis and treatment of the underlying cause
• What are the major causes of DIC?

  • Major trauma or burns
  • Multi-organ failure
  • Severe sepsis or infection
  • Severe obstetric complications
  • Solid tumours or haematological malignancies
  • Acute promyelocytic leukaemia (APL)
• What are common presentations of patients with DIC?


  Excessive bleeding, fever, confusion, and potential coma
• What are the physical signs of DIC?


  Petechiae, bruising, confusion, and hypotension
• What conditions should be considered in the differential diagnosis for DIC?


  • Other coagulopathies
  • Sepsis
  • Multi-organ failure
• What blood tests are important in diagnosing DIC?

  FBC showing thrombocytopenia, blood film showing schistocytes, raised D-dimer, and clotting profile abnormalities
• What does a blood film show in DIC?


  Schistocytes due to microangiopathic haemolytic anaemia (MAHA)
• What changes occur in the clotting profile in DIC?

  Increased prothrombin time, increased APTT, and decreased fibrinogen
• What is the role of supportive care in DIC management?


  To manage symptoms and prevent complications
• What treatments may be necessary in DIC management?

  Transfusions of platelets or clotting factors, and possibly anticoagulation therapy